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https://www.readbyqxmd.com/read/28549643/hypertonic-saline-for-raised-intracranial-pressure-following-aneurysmal-subarachnoid-hemorrhage-a-systematic-review
#1
REVIEW
Christopher R Pasarikovski, Naif M Alotaibi, Fawaz Al-Mufti, R Loch Macdonald
BACKGROUND: The use of hyperosmolar agents such as mannitol or hypertonic saline (HTS) to control high intracranial pressure (ICP) in traumatic brain injury patients has been well studied. However, the role of HTS in the management of aneurysmal subarachnoid hemorrhage (aSAH)-associated raised ICP is still unclear. METHODS: We performed a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The primary outcome of this review is to quantify ICP reduction produced by HTS and its effect on clinical outcomes defined by any standardized functional score...
May 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28548598/associations-between-endothelin-polymorphisms-and-aneurysmal-subarachnoid-hemorrhage-clinical-vasospasm-delayed-cerebral-ischemia-and-functional-outcome
#2
Christoph J Griessenauer, Robert M Starke, Paul M Foreman, Philipp Hendrix, Mark R Harrigan, Winfield S Fisher, Nilesh A Vyas, Robert H Lipsky, Mingkuan Lin, Beverly C Walters, Jean-Francois Pittet, Mali Mathru
OBJECTIVE Endothelin-1, a potent vasoconstrictor, and its receptors may be involved in the pathogenesis of aneurysmal subarachnoid hemorrhage (aSAH), clinical vasospasm, delayed cerebral ischemia (DCI), and functional outcome following aSAH. In the present study, common endothelin single nucleotide polymorphisms (SNPs) and their relation to aSAH were evaluated. METHODS Blood samples from all patients enrolled in the Cerebral Aneurysm Renin Angiotensin System (CARAS) study were used for genetic evaluation. The CARAS study prospectively enrolled patients with aSAH at 2 academic institutions in the US from 2012 to 2015...
May 26, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28548595/effect-of-treatment-modality-on-in-hospital-outcome-in-patients-with-subarachnoid-hemorrhage-a-nationwide-study-in-japan-j-aspect-study
#3
Ryota Kurogi, Akiko Kada, Kunihiro Nishimura, Satoru Kamitani, Ataru Nishimura, Tetsuro Sayama, Jyoji Nakagawara, Kazunori Toyoda, Kuniaki Ogasawara, Junichi Ono, Yoshiaki Shiokawa, Toru Aruga, Shigeru Miyachi, Izumi Nagata, Shinya Matsuda, Shinichi Yoshimura, Kazuo Okuchi, Akifumi Suzuki, Fumiaki Nakamura, Daisuke Onozuka, Akihito Hagihara, Koji Iihara
OBJECTIVE Although heterogeneity in patient outcomes following subarachnoid hemorrhage (SAH) has been observed across different centers, the relative merits of clipping and coiling for SAH remain unknown. The authors sought to compare the patient outcomes between these therapeutic modalities using a large nationwide discharge database encompassing hospitals with different comprehensive stroke center (CSC) capabilities. METHODS They analyzed data from 5214 patients with SAH (clipping 3624, coiling 1590) who had been urgently hospitalized at 393 institutions in Japan in the period from April 2012 to March 2013...
May 26, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28540119/a-case-of-a-cerebral-cavernous-malformation-of-the-third-ventricle-that-caused-the-syndrome-of-inappropriate-secretion-of-antidiuretic-hormone
#4
Takahiro Sasaki, Nobuhide Hayashi, Nagatsuki Tomura, Eisaku Tsuji, Hideo Okada, Toshikazu Kuwata
BACKGROUND: Cerebral cavernous malformations (CCMs, also known as cavernous hemanigiomas) of the third ventricle are uncommon. Here, we present a rare case of a CCM that caused the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). CASE DESCRIPTION: A 68-year-old man presented with acute-onset cognitive and memory disturbance. Endocrinological examinations revealed hyponatremia due to SIADH. Computed tomography indicated a high-density mass in the third ventricle that caused left unilateral hydrocephalus due to obstruction of the foramen Monroe...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28536682/a-case-of-intramural-coronary-amyloidosis-associated-with-hemodialysis
#5
Faisal M Huq Ronny, George Kleinman, Paul James Kurtin, John Thomas Fallon
Dialysis-related amyloidosis predominantly occurs in osteo-articular structures and dialysis-related amyloid (DRA) substances also deposit in extra-articular tissues. Clinical manifestations of DRA include odynophagia, gastrointestinal hemorrhage, intestinal obstruction, kidney stones, myocardial dysfunction, and subcutaneous tumors. The pathological characteristics of DRA in the heart of hemodialysis patients have rarely been reported. We report the case of a 73-year-old female with a history of cerebral palsy and end-stage renal disease status post two failed renal transplants who had been on hemodialysis for 30 years...
January 2017: Autopsy & case reports
https://www.readbyqxmd.com/read/28535419/comparison-of-the-efficacy-of-fixed-dose-enoxaparin-and-adjusted-dose-unfractionated-heparin-in-patients-with-cerebral-venous-thrombosis
#6
Pat Korathanakhun, Chusana Petpichetchian, Wongchan Petpichetchian, Pornchai Sathirapanya
OBJECTIVE: Anticoagulants are the standard treatment for cerebral venous thrombosis (CVT). Although low-molecular-weight heparin (LMWH) is recommended in CVT, the specific type and dosage regimen of LMWH have never been specifically suggested. This study compared the clinical outcomes and adverse events in patients who received adjusted-dose unfractionated heparin (AD-UFH) versus fixed-dose enoxaparin (FD-E). METHODS: A retrospective cohort study was conducted at a university hospital in Thailand...
May 10, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28535372/a-brain-region-specific-neural-pathway-regulating-germinal-matrix-angiogenesis
#7
Shang Ma, Devi Santhosh, Peeyush Kumar T, Zhen Huang
Intimate communication between neural and vascular cells is critical for normal brain development and function. Germinal matrix (GM), a key primordium for the brain reward circuitry, is unique among brain regions for its distinct pace of angiogenesis and selective vulnerability to hemorrhage during development. A major neonatal condition, GM hemorrhage can lead to cerebral palsy, hydrocephalus, and mental retardation. Here we identify a brain-region-specific neural progenitor-based signaling pathway dedicated to regulating GM vessel development...
May 22, 2017: Developmental Cell
https://www.readbyqxmd.com/read/28530081/-evaluation-of-the-association-between-antihypertensive-treatment-and-development-of-stroke
#8
Margarita Fraimovitch, Yosef Tzvi, Reuven Zimlichman
INTRODUCTION: An ischemic stroke is an event that occurs due to cerebral vascular disease and is directly related to the degree of vascular damage. This process is associated with atherosclerosis progression and is influenced by the presence of cardiovascular risk factors. AIMS: One of the goals of our research was to examine whether specific medications used for treating hypertension are associated with the development of strokes. METHODS: In a retrospective study of patients who were hospitalized between the years 2003-2008 due to a cerebrovascular accident (CVA) or a transient ischemic attack (TIA), 916 cases of stroke patients were reviewed...
September 2016: Harefuah
https://www.readbyqxmd.com/read/28527856/a-bloody-mess
#9
Michael C Brodsky, Valérie Biousse
A 15-year-old girl presented with a unilateral sixth nerve palsy and papilledema following a severe headache. MR imaging showed thrombosis of the superior sagittal sinus and proximal right transverse sinus that were attributed to oral contraceptive use after a coagulation workup was negative. Systemic anticoagulation caused a hemorrhagic papillopathy in both eyes, raising the question as to whether anticoagulation should be discontinued. Diagnostic and management issues regarding cerebral venous sinus thrombosis with secondary intracranial hypertension are discussed...
May 17, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28527588/mechanical-thrombectomy-for-acute-ischemic-stroke-in-a-patient-with-concomitant-spontaneous-intracerebral-hemorrhage
#10
Stefano Forlivesi, Paolo Bovi, Manuel Cappellari
Data from randomized clinical trials and current guidelines suggest that patients with anterior circulation occlusion with contraindications to intravenous thrombolysis may benefit from direct mechanical thrombectomy. Nevertheless, no data are available on the efficacy and safety of direct mechanical thrombectomy in patients with concomitant spontaneous intracerebral hemorrhage. We report the case of a 51-year-old woman with a spontaneous intracerebral hemorrhage in the right parietal and occipital lobes, who experienced, 7 days later, an occlusion of the proximal left middle cerebral artery...
May 17, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28527261/-posterior-reversible-encephalopathy-syndrome-report-of-a-fatal-case-and-analysis-of-predictive-factors-of-a-poor-prognosis
#11
Moisés Ulises Torres, Ligia Victoria Delgado, Natalia Giraldo, Piedad Urueña, Sergio Franco, Olga Helena Hernández
Posterior reversible encephalopathy syndrome is an illness with multiple causes and distinctive clinicalradiological characteristics that should be known by intensivists and emergency room physicians for a timely diagnosis and treatment. A fatal case of posterior reversible encephalopathy syndrome is presented, and the risk factors related to the outcome are identified.A 60-year-old man without a relevant medical history arrived at the emergency room presenting with depressed consciousness, seizures, and high blood pressure...
April 1, 2017: Biomédica: Revista del Instituto Nacional de Salud
https://www.readbyqxmd.com/read/28526764/subarachnoid-hemorrhage-severely-impairs-brain-parenchymal-cerebrospinal-fluid-circulation-in-nonhuman-primate
#12
Romain Goulay, Julien Flament, Maxime Gauberti, Michael Naveau, Nolwenn Pasquet, Clement Gakuba, Evelyne Emery, Philippe Hantraye, Denis Vivien, Romina Aron-Badin, Thomas Gaberel
BACKGROUND AND PURPOSE: Subarachnoid hemorrhage (SAH) is a devastating form of stroke with neurological outcomes dependent on the occurrence of delayed cerebral ischemia. It has been shown in rodents that some of the mechanisms leading to delayed cerebral ischemia are related to a decreased circulation of the cerebrospinal fluid (CSF) within the brain parenchyma. Here, we evaluated the cerebral circulation of the CSF in a nonhuman primate in physiological condition and after SAH. METHODS: We first evaluated in physiological condition the circulation of the brain CSF in Macaca facicularis, using magnetic resonance imaging of the temporal DOTA-Gd distribution after its injection into the CSF...
May 19, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28526762/exacerbation-of-thromboinflammation-by-hyperglycemia-precipitates-cerebral-infarct-growth-and-hemorrhagic-transformation
#13
Jean-Philippe Desilles, Varouna Syvannarath, Véronique Ollivier, Clément Journé, Sandrine Delbosc, Célina Ducroux, William Boisseau, Liliane Louedec, Lucas Di Meglio, Stéphane Loyau, Martine Jandrot-Perrus, Louis Potier, Jean-Baptiste Michel, Mikael Mazighi, Benoit Ho-Tin-Noé
BACKGROUND AND PURPOSE: Admission hyperglycemia is associated with a poor outcome in acute ischemic stroke. How hyperglycemia impacts the pathophysiology of acute ischemic stroke remains largely unknown. We investigated how preexisting hyperglycemia increases ischemia/reperfusion cerebral injury. METHODS: Normoglycemic and streptozotocin-treated hyperglycemic rats were subjected to transient middle cerebral artery occlusion. Infarct growth and brain perfusion were assessed by magnetic resonance imaging...
May 19, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28525977/the-intracerebral-hemorrhage-acutely-decreasing-arterial-pressure-trial-ii-ich-adapt-ii-protocol
#14
Laura Gioia, Ana Klahr, Mahesh Kate, Brian Buck, Dariush Dowlatshahi, Thomas Jeerakathil, Derek Emery, Kenneth Butcher
BACKGROUND: Aggressively lowering blood pressure (BP) in acute intracerebral hemorrhage (ICH) may improve outcome. Although there is no evidence that BP reduction changes cerebral blood flow, retrospective magnetic resonance imaging (MRI) studies have demonstrated sub-acute ischemic lesions in ICH patients. The primary aim of this study is to assess ischemic lesion development in patients randomized to two different BP treatment strategies. We hypothesize aggressive BP reduction is not associated with ischemic injury after ICH...
May 19, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28524787/cerebral-hemorrhage-in-monozygotic-twins-with-hereditary-hemorrhagic-telangiectasia-case-report-and-hemorrhagic-risk-evaluation
#15
Abbas Rattani, Michael C Dewan, Vickie Hannig, Robert P Naftel, John C Wellons, Lori C Jordan
The authors present a case of monozygotic twins with hereditary hemorrhagic telangiectasia (HHT) who experienced cerebral arteriovenous malformation (AVM) hemorrhage at a very young age. The clinical variables influencing HHT-related AVM rupture are discussed, and questions surrounding the timing of screening and intervention are explored. This is only the second known case of monozygotic HHT twins published in the medical literature, and the youngest pair of first-degree relatives to experience AVM-related cerebral hemorrhage...
May 19, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28524121/-the-use-of-high-flow-extracranial-intracranial-artery-bypass-in-pathology-of-the-cerebral-and-brachiocephalic-arteries-technical-features-and-surgical-outcomes
#16
A V Dubovoy, K S Ovsyannikov, V E Guzhin, A V Cherepanov, D M Galaktionov, A M Perfil'ev, A O Sosnov
BACKGROUND: Poor outcomes of surgical treatment for complex cerebral aneurysms due to the development of cerebral ischemia were the cause to use cerebral revascularization surgery for this pathology. OBJECTIVE: the study objective was to master a high-flow extracranial-intracranial (EC-IC) artery bypass technique and evaluate its application in surgical treatment of complex and giant cerebral aneurysms as well as complex lesions of the brachiocephalic arteries. MATERIAL AND METHODS: Fifty two patients underwent high-flow IC-EC bypass surgery; of these, 34 patients had complex cerebral aneurysms, and 18 patients had complex stenotic occlusive lesions of the brachiocephalic arteries...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28524035/-comparison-of-risk-of-death-between-older-and-non-older-critical-patients-in-icu-a-retrospective-cohort-study-of-consecutive-3-years
#17
Yeting Zhou, Daoming Tong, Shaodan Wang, Liansong Liu, Song Ye, Benwen Xu
OBJECTIVE: To investigate the risk of death between older and non-older critical patients in intensive care unit (ICU) in Shuyang People's Hospital. METHODS: A retrospective cohort study was conducted. The critical patients who aged 15 or above, and admitted to ICU of Shuyang People's Hospital from January 2014 to December 2016 were enrolled, and all the data was collected from the registration and electronic medical records in the ICU. The prevalence and causes of death in ICU critical patients during the study period were observed...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28523383/anterior-sacral-meningocele-presenting-as-intracystic-bleeding
#18
Ignacio Javier Gilete-Tejero, Marta Ortega-Martínez, Jacinto Mata-Gómez, María Rico-Cotelo, Luis Miguel Bernal-García, Beatriz Yerga-Lorenzana, Ignacio Casado-Naranjo
PURPOSE: To report a case of anterior sacral meningocele with intralesional bleeding secondary to sacrococcygeal trauma. Likewise, there is a discussion about the physiopathology and the surgical approach to these types of lesions. METHODS: A 43-year-old man diagnosed with Marfan syndrome suffered sacrococcygeal trauma. He was admitted to the emergency room due to symptoms of headache, nausea, and lower limb subjective weakness. CT and MRI showed a large retroperitoneal mass with hemorrhagic content close to the sacrum...
May 18, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28522673/systolic-blood-pressure-within-24%C3%A2-hours-after-thrombectomy-for-acute-ischemic-stroke-correlates-with-outcome
#19
Eva A Mistry, Akshitkumar M Mistry, Mohammad Obadah Nakawah, Nicolas K Khattar, Enzo M Fortuny, Aurora S Cruz, Michael T Froehler, Rohan V Chitale, Robert F James, Matthew R Fusco, John J Volpi
BACKGROUND: Current guidelines suggest treating blood pressure above 180/105 mm Hg during the first 24 hours in patients with acute ischemic stroke undergoing any form of recanalization therapy. Currently, no studies exist to guide blood pressure management in patients with stroke treated specifically with mechanical thrombectomy. We aimed to determine the association between blood pressure parameters within the first 24 hours after mechanical thrombectomy and patient outcomes. METHODS AND RESULTS: We retrospectively studied a consecutive sample of adult patients who underwent mechanical thrombectomy for acute ischemic stroke of the anterior cerebral circulation at 3 institutions from March 2015 to October 2016...
May 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28522231/large-amount-of-cannabis-ingestion-resulting-in-spontaneous-intracerebral-hemorrhage-a-case-report
#20
Kunakorn Atchaneeyasakul, Luis F Torres, Amer M Malik
Although multiple cases of cannabis-associated ischemic stroke have been reported, there are only 2 reported cases of hemorrhagic stroke with an associated cerebral vasoconstriction. To our knowledge, we present the first case of basal ganglia hemorrhage after a large-volume oral ingestion of cannabis without other identified risk factors. In our case, cerebral digital subtraction angiography within 24 hours of presentation did not reveal vasoconstriction leading to a possible alternative explanation for hemorrhagic stroke, including cannabis-induced transient arterial hypertension and autoregulation disruption...
May 15, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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